Bone brittleness has long been a bothersome condition affecting women as they get older. "It's been called by some doctors as a silent disease," says Karl Jepsen, Ph.D., associate chairperson of research and the professor of orthopaedical surgery at Michigan Medicine, noting, "One of the biggest trials when you're looking at growth-related bone fragility is to recognize people who will fracture."
Jepsen, the lead author on this new study published in the Journal of Bone and Mineral Research, that inspected the bone traits of 198 midlife women transitioning through menopause for 14 years. The primarily goals is in identifying women who will experience bone brittleness well in advance of fracture.
"Current detection for bone fragility takes place when the patient is around 65 years of age," Jepsen explains. "We were optimistic that this study would give us an opportunity to identify those patients as early as 30 years before they fracture based on their bone traits. That means we would have an opening to intervene before the fracture happens, instead of after the fact."
Jepsen adds that comprehension how bone structure and bone mass change during aging is not well understood on an discrete basis. "We imagined that age-related changes in bone traits also depend on outdoor bone size, which is easily measured," he says. "The work we had done previously on young adults with stress bone fracture risks, started when we found those with narrow bones were at a higher risk of evolving stress fractures."
Identifying Bone Traits Focuses On 198 Midlife Women
Jepsen and his colleagues from Michigan Medicine Department of Orthopaedic Surgery worked with Sioban Harlow, Ph.D., professor at the University of Michigan School of Public Health and director of the Center for Midlife Science, Carrie Karvonen-Gutierrez, Ph.D., M.P.H., assistant professor at the U-M SPH, and Jane Cauley, DRPH, at the University of Pittsburgh, who had entree to a large unit of women transit through menopause called the Study of Women's Health Across the Nation.
The database had been following the subjects since 1996. Women who signed up at that time had to be between 42 and 52 years of age, have a whole uterus and had at least one menstrual period in the previous three months. Also, the subjects had about 14 annual study visits that included sizes, such as bone density scans, of their hip and spine.
Investigating X-ray Images
The research team analyzed dual-energy X-ray absorptiometry pictures, which measure bone mineral compactness, on hips over the 14-year period to distinguish if there are changes happening in each woman.
They found that over that period, women experienced different changes in bone mineral content and bone area within the hip, in similar changes in areal bone mineral density. Furthermore, the change in bone mineral content and bone area interrelated negatively with baseline external size of the neck of the femur just below the hip joint.
"Our results were opposite to all opportunities of how we assumed this would work," Jepsen says. "Founded on previous work, we presumed that bone expansion acts to mechanically offset bone loss, but we found some women seemed to have hip bones that were increasing in strength during the menopausal changeover while others appear to be losing strength."
Moving Forward To Further Researches On Bone Changes In Menopausal Women
"This study established for the first time that we can track bone changes happening separately in women during menopause," Jepsen says. He hopes these consequences are a stepping point for extra research.
Also, he notes this work further establishes the inconsistency in each person's body. "Bone is constantly re-forming itself, but with age and menopause, considerable decays in bone strength can occur," Jepsen says. "This study help out to demonstrate how much that process can vary importantly among women."
